Transthyretin Amyloid Cardiomyopathy Market Set for Explosive Growth to US$ 64.09 Billion by 2033, Led by North America | Key Players - Pfizer Inc., Ionis Pharmaceuticals, Inc

Market Overview

The Transthyretin amyloid cardiomyopathy (ATTR-CM) was valued at US$ 2.92 Billion n 2023. The global transthyretin amyloid cardiomyopathy (ATTR-CM) market size reached US$ 4.32 Billion in 2024 and is expected to reach US$ 64.09 Billion by 2033, growing at a CAGR of 35.3% during the forecast period 2025-2033.The market is growing due to rising disease awareness, improved diagnostic techniques, increasing elderly population, and advancements in targeted therapies. Regulatory approvals of novel drugs and expanding clinical research pipelines further accelerate treatment adoption and market expansion globally.

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United States: Key Industry Developments
✅ October 2025: Alnylam Pharmaceuticals expanded AMVUTTRA (vutrisiran) commercialization efforts following U.S. approval for ATTR-CM, achieving over 1,400 patients on therapy by year-end and driving TTR franchise revenues toward $2.25 billion guidance.

✅ August 2025: Attruby received FDA approval for its novel ATTR-CM therapy, igniting market competition against Pfizer's tafamidis dominance and promising improved pricing and trial data for broader adoption.

✅ July 2025: Pfizer's Vyndaqel family (tafamidis) reported 60% global sales growth year-over-year, fueled by enhanced ATTR-CM diagnosis rates and U.S. affordability programs amid aging population demands.

Japan: Key Industry Developments
✅ July 2025: Japanese PMDA granted approval for Alnylam's AMVUTTRA in ATTR-CM treatment, enabling market entry alongside EU and UK nods, with focus on precision medicine integration via AI diagnostics.

✅ June 2025: MHLW updated ATTR-CM guidelines to incorporate real-world evidence and accelerated reviews for RNAi therapies like vutrisiran, supporting aging demographics and digital health initiatives.

✅ March 2025: Market projections highlighted Japan ATTR-CM treatment growth to USD 0.4 billion base, driven by regulatory shifts toward personalized therapies and investments in early detection tools.

Latest Mergers & Acquisition

Bayer AG - Acquisition of European Rights to Acoramidis from BridgeBio Pharma (March 2024; commercial impact extending into 2025):
Bayer secured exclusive European commercialization rights to acoramidis, a late-stage oral therapy for ATTR-CM, in a deal valued at up to approximately $310 million including milestone payments and royalties. Strategically, the transaction strengthens Bayer's rare cardiovascular portfolio and positions the company to compete more aggressively in the expanding European ATTR-CM therapeutic market.

Novo Nordisk - ATTR Amyloidosis Business Acquisition from Prothena Corporation (Milestone progress through 2025):
Novo Nordisk acquired Prothena's ATTR amyloidosis portfolio in a transaction valued at up to $1.2 billion including contingent milestones, with continued development momentum into 2025. The acquisition enhances Novo Nordisk's rare disease pipeline, particularly in amyloid-depleting antibody therapies targeting cardiac manifestations such as ATTR-CM, supporting long-term expansion in specialty cardiology.

AstraZeneca - Strategic Collaboration with Ionis Pharmaceuticals for Eplontersen (Regulatory expansion through 2025):
Under a deal structure including approximately $200 million upfront and up to $2.9 billion in milestones, AstraZeneca secured global co-development and commercialization rights for eplontersen, an antisense therapy for ATTR indications. By 2025, regulatory progress significantly enhanced the asset's commercial value, reinforcing AstraZeneca's rare disease cardiovascular pipeline and strengthening Ionis' RNA-targeting platform reach.

Novartis - Acquisition of Avidity Biosciences (October 2025; approx. $12 billion):
Novartis acquired Avidity Biosciences in a transaction valued at roughly $12 billion to expand its RNA-based therapeutic capabilities and rare disease portfolio. While not exclusively focused on ATTR-CM, the deal strengthens Novartis' strategic positioning in precision and genetic medicines, indirectly influencing competitive dynamics within rare cardiovascular and amyloidosis markets globally.

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Key Players:
Pfizer Inc. - 78% market share; leading with its tafamidis therapy (Vyndaqel/Vyndamax), strong clinical evidence and global commercial infrastructure make it the dominant ATTR-CM player.

Alnylam Pharmaceuticals, Inc. - 21% share; robust RNA-interference portfolio (patisiran, vutrisiran) and expanding regulatory approvals position it as the key competitor to stabilizer therapies.

Ionis Pharmaceuticals, Inc. - 0.4% share; core strength in antisense oligonucleotide technology with inotersen and partnered programs that broaden rare disease treatment potential.

BridgeBio Pharma (Eidos Therapeutics) - 8.5% share; differentiated by its oral TTR stabilizer (acoramidis/Attruby) gaining commercial traction and challenging incumbents.

Akcea Therapeutics - 9% share; benefits from Ionis's antisense platform with focused rare disease deployment and targeted patient outreach.

Market Segmentation:

The ATTR-CM market exhibits distinct segmentation patterns that reflect disease subtypes, therapeutic innovations, and distribution dynamics, driving targeted growth amid rising prevalence in aging populations. By Type, Familial (hereditary) ATTR-CM-driven by genetic mutations leading to early-onset cardiac amyloidosis-accounts for a notable share due to improved genetic screening and orphan drug incentives, while Wild-type ATTR-CM dominates with higher incidence in elderly males, fueled by enhanced diagnostics like scintigraphy and representing over 50% of cases in key markets like North America. These segments underscore market significance through precision medicine advances, with stabilizers like tafamidis propelling familial uptake via proven mortality reductions.

Drug Type segmentation highlights Transthyretin Stabilizers (e.g., tafamidis, acoramidis) commanding over 54% share in 2024 owing to FDA approvals, oral convenience, and robust Phase 3 data showing slowed cardiomyopathy progression, positioning them as first-line therapies. RNAi Therapies (e.g., patisiran, vutrisiran) gain traction via gene-silencing mechanisms for hereditary cases, supported by expanding labels and subcutaneous formulations, while Others (aggregation inhibitors, monoclonal antibodies) emerge as pipeline drivers amid R&D investments exceeding hundreds of millions. Growth here stems from blockbuster potential, with stabilizers anchoring revenue amid a market projected to surge from $4.3B in 2024 to $64B by 2033.

Distribution Channels reveal Hospital Pharmacies leading due to specialized cardiology settings, infusion requirements for RNAi, and reimbursement pathways, ensuring rapid access for high-cost therapies in amyloidosis centers. Retail Pharmacies grow steadily via oral stabilizers' outpatient shift, enhancing patient adherence, while Online Pharmacies accelerate post-pandemic with convenience for chronic management, though limited by cold-chain logistics. Collectively, these channels amplify significance by bridging urban-rural divides, with North America dominating geographically via infrastructure and awareness, followed by Europe's reimbursement evolution and Asia-Pacific's aging demographics.

Regional Insights:

North America
North America dominated the market research services market in 2025, benefiting from advanced tech adoption and data-driven decisions in sectors like healthcare and FMCG. Growth is supported by stable economic conditions and innovations like AI platforms from companies such as Meta and AlphaSense. Quantifiable indicators include its position as the top region, with overall services market expansion at 3.6% CAGR into 2026.

Europe
Europe's market research and public opinion polling sector reached €25.2 billion in 2026, with 3.7% annual revenue growth projected. Advertising and market research grew at a 1.0% CAGR from 2020-2025, with over 522,000 businesses by 2025. Western Europe ranks second globally, fueled by online surveys and analytics-led models amid economic recovery.

Asia Pacific
The Asia Pacific market research industry is projected to hit $38.2 billion by 2026 at a 9.4% CAGR from 2021-2026, driven by e-commerce, healthcare, and AI/ML adoption. High economic growth over 6% in key markets like China and India boosts demand for digital analytics and innovative research. Sectors such as financial services and consumer goods amplify opportunities through scalable data handling.

Market Dynamics:

The Transthyretin amyloid cardiomyopathy (ATTR-CM) market is propelled by several key growth drivers. Rising disease prevalence, particularly among aging populations in regions like North America and Asia-Pacific, increases demand for targeted therapies, as ATTR-CM emerges as a leading cause of heart failure in older adults. Advancements in diagnostic technologies, including non-invasive imaging like cardiac MRI, scintigraphy, and biomarker assays, enable earlier detection of both hereditary (hATTR-CM) and wild-type (wtATTR-CM) forms, expanding the treatable patient pool. Regulatory approvals and label expansions for innovative treatments-such as TTR stabilizers like tafamidis, RNAi therapies like patisiran and vutrisiran, and emerging gene-editing options-accelerate market adoption, supported by favorable reimbursement policies and FDA milestones. Robust R&D investments by leading players like Pfizer, Alnylam Pharmaceuticals, and Intellia Therapeutics fuel a pipeline of disease-modifying drugs, with projected CAGRs exceeding 30% through 2034 amid growing healthcare expenditures.

Current industry trends further bolster expansion, including a shift toward next-generation RNA-based medicines for longer durability and easier administration, alongside increased focus on ATTR-CM within broader transthyretin amyloidosis markets. However, primary restraints temper this growth. High treatment costs for specialized therapies, coupled with limited accessibility in cost-sensitive emerging markets, hinder widespread uptake despite rising prevalence. Stringent regulatory requirements demand large, long-term clinical trials to demonstrate efficacy and safety, delaying new therapy launches and escalating development expenses. Diagnostic complexity persists, as ATTR-CM is often misdiagnosed or underrecognized due to overlapping symptoms with other cardiomyopathies, restricting early intervention. Economic pressures, including competition from off-label cardiovascular drugs and variable reimbursement landscapes, also challenge market penetration in diverse global settings.

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